Heart Valve Prosthesis Implantation ; Humans ; Tricuspid Valve Insufficiency ; diagnosis ; etiology ; therapy

Dermatomycoses ; drug therapy ; Drug Therapy, Combination ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Sexually Transmitted Diseases ; drug therapy ; Skin Diseases ; drug therapy ; Skin Diseases, Viral ; drug therapy

Female ; Humans ; Laryngeal Diseases ; etiology ; Middle Aged ; Parathyroid Neoplasms ; complications

Adolescent ; Antimetabolites, Antineoplastic ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Leucovorin ; administration & dosage ; Lymphoma, Non-Hodgkin ; drug therapy ; Male ; Methotrexate ; administration & dosage ; adverse effects ; blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Thirty four residents of general practice and 11 students of junior college to undergraduate program were evaluated with the mini-clinical evaluation exercise (mini-CEX) when they were rotated to community clinics or the ward of general practice in Zhongshan Hospital from September 2009 to February 2010. The reliability and validity of mini-CEX for rotation examination in general practice training was assessed. Forty five trainees and 9 clinical faculty members completed 81 mini-CEX evaluations. The Cronbach's alpha coefficient was 0. 932. Criterion-related validity for mini-CEX overall competence with the end examination of rotation was O.53 ( P ＜ 0.001 ). The results indicate that mini-CEX may be an appropriate evaluation tool for rotation examination in general practice training.

Objective To analyze the ultrasonic features of thyroid microcarcinoma (TMC) and the causes of misdiagnosis. Methods The ultrasonic features including shape, margin, echogenecity, microcalcification, vascularity and lymphadenopathy were analyzed retrospectively in 26 pathologically-proven TMC patients. Results In 26 cases, 11 cases were diagnosed correctly before operation (11/26, 42.31%), 12 cases were misdiagnosed (12/26, 46.15%) as adenoma or benign nodule, and 3 cases were missed diagnosed (3/26, 11.54%). Among the 23 cases detected on ultrasound, 21 cases were solid and hypoechoic (21/23, 91.30%);19 cases were ill-defined (19/23, 82.61%);12 cases were taller than wide in shape (12/23, 52.17%); 14 cases had microcalcification (14/23, 60.87%); 7 cases showed central or peripheral blood flow signals (7/23,30.43%) with arterial resistance index>0.70 in 3 lesions and<0.70 in 4 lesions. Conclusions Several ultrasonographic features are helpful in identiifcation of TMC, including hypo/iso-echogenecity, ill-deifned margin, taller-than-wide shape, microcalciifcation, arterial signals with high resistance index, and abnormal lymphadenopathy. Moreover, for cases with multiple lesions, to the potential co-existence of benign and malignant lesions should be considered.

Objective To investigate the survival status and pathogens in adult patients with severe community-acquired pneumonia (SCAP) for the past ten years in our hospital. Methods A total of 159 adult patients with SCAP were enrolled for this study from January 2007 to December 2016 in our hospital. Patients were divided into early stage group (from January 2007 to December 2011, n=71) and late stage group (from January 2012 to December 2016, n=88). The clinical data, pathogen distribution and prognosis were compared between two groups. Results (1) The proportion of patients with blood urea nitrogen (BUN) > 7.1 mmol/L was significantly higher in late stage group than that of early stage group (P<0.05). There were no significant differences in baseline data, vital signs, imaging findings and other laboratory examinations between the two groups (P>0.05). (2) For distribution of pathogens, 42 and 49 cases were detected pathogens in early stage group and late stage group. The detection rate of Legionella pneumophila was significantly higher in late stage group than that in early stage group (26.5% vs. 7.1%, P<0.05). (3) For complications, the incidence of septic shock was significantly higher in late stage group than that in the early stage group (22.7%vs. 9.9%, P<0.05). The fatality rate within 30 d after admission was significantly higher in late stage group than that of early stage group (43.2%vs. 25.4%, P<0.05). Results of multi-factor Cox proportional hazard regression analysis showed that septic shock and respiratory acidosis were independent risk factors of mortality in early stage group (P<0.05) while septic shock, chronic obstructive pulmonary disease (COPD) and multi-lobar infiltrates were independent risk factors of mortality in late stage group ( P<0.05). Conclusion In the past ten years, basic clinical characteristics of adult patients with SCAP in our hospital have changed little, but detection rate of legionella has showed increasing trend, and the short-term mortality rate has increased. Whether or not patients are combined with septic shock is a key factor affecting the prognosis.

OBJECTIVETo explore the association of 8-hydroxyguanine glycosidase OGG1 Ser326Cys polymorphism with semen quality and the risk of male infertility.

METHODSThis case-control study included 620 idiopathic infertile patients and 385 normal fertile controls. We determined their genotypes by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and analyzed their semen quality by computer-aided semen analysis (CASA).

RESULTSThe individuals with OGG1 326 Cys/Cys showed significantly lower sperm motility and concentration ([52.1 +/- 26.7]% and (3.75 +/- 0.91) x 10(6)/ml, ln transformed value) than the Ser/Ser carriers ([59.0 +/- 21.8] % and (4.12 +/- 0.88) x 10(6)/ml, ln transformed value) (P < 0.05). The risk of male infertility increased 69% in the OGG1 326Cys allele carriers as compared with the Ser carriers (OR = 1.69, 95% CI: 1.24 -2.31).

CONCLUSIONOGG1 326 Ser/Cys polymorphism might contribute to the risk of male infertility in the southern Chinese population.

Adult ; Case-Control Studies ; DNA Glycosylases ; genetics ; Genotype ; Humans ; Infertility, Male ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Semen Analysis ; Young Adult

Objective To evaluate the mental status of malignant hematologic patients, explore the morbidity of depression in malignant hematologic patients, and investigate valid interventional treatment on them. Methods 134 malignant hematologic patients were evaluated by SDS and HAMD, and 49 patientswere selected who was diagnosed depressive disorder then randomly divided into 2 groups. One was experimental group and the other control group. The patients of experimental group were treated with antidepressant drug and mental intervention during common therapy, while the patients of control group only took common therapy. The change of immunological function after treatment was detected. Results The morbidity of depression in malignant hematologic patients was 37 %. The scores of SDS and HAMD were significandy decreased and the depressive symptoms were notablely improved in experimental group and there were significant differences after treatment and before treatment (P <0.01), but there was no significant difference in control group (P >0.1). The NPY plasma levels significantly increased after treatment in experimental group(P <0.01), but there was no significant difference in control group(P >0.05); the CD+4/CD+4 values of patients in the experimental group were significantly increased after treatments. Statistical analysis revealed significant differences in the experimental group patients between pre-treat and after-treat (P <0,05),but no obvious difference in the patients of control group (P>0.5). Conclusion Mental intervention and antidepressive treatment can improve all of the depression, immunological function and quality of life of malignant hematologic patients.

Objective To study needs of training of trainers(ToT)in mini-clinical evaluation exercise(mini-CEX)and its effectiveness.Methods One hundred and fourteen doctors involved in TOT for mini-CEX were interviewed with questionnaire before and after training for their satisfaction of training and fifty of them scored the training videos.Results Before the training.39%(44/114)of doctors involved in TOT knew mini-CEX and 97%(111/114)of them hoped to know how to carry out mini-CEX thronsh training.When the training finished,30%(34/114)tO 55%(63/114)of them could completely understand seven items of examinations of mini-CEX.Fifty doctors involved in TOT scored the training videos after the training.There was signifieant difference in scores between TOT and standard scoring on training video 1 for teaching of coronary heart disease and video 2 for teaching of hematochezia(P<0.05).No significant difference Was found in scores between TOT and standard scoring on the video 3 for teaching of abdomihal pain(P>0.05).as well as those between TOT with five or less years experience and those with more than five years experience(P>0.05).Conclusions Currently,doctors involved in TOT have more demands on mini-CEX.However,effectiveness of short-course training for mini-CEX is not satisfactory,and pattern of its training should be improved further.